Dermatology Duluth LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DERMATOLOGY DULUTH LLC

Practice address

4316 Rice Lake Rd Ste 101
Duluth, MN 55811-4012

Phone

(218) 740-7400

Fax

(218) 740-7401

NPI assigned

Jul 28, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Hilary Claire Reich, MDNPI 1306167978

Title

Sole Partner

Phone

(612) 618-5444

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hilary Claire Reich, M.D.

  • Dermatology Physician
  • Dultuh, MN
  • NPI 1306167978
  Medicare reassignment Care Compare group NPD Authorized official
• Erika Rhiannon Butkiewicz, PA-S

  • Physician Assistant
  • Duluth, MN
  • NPI 1336871680
  Medicare reassignment Care Compare group NPD
• Brooke Erickson, MD

  • Dermatology Physician
  • Edina, MN
  • NPI 1457841405
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627430400000",
    "number": "1285307975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4316 RICE LAKE RD STE 101",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558114012",
            "telephone_number": "218-740-7400",
            "fax_number": "218-740-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4316 RICE LAKE RD STE 101",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558114012",
            "telephone_number": "218-740-7400",
            "fax_number": "218-740-7401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY DULUTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A",
        "authorized_official_last_name": "REICH",
        "authorized_official_first_name": "HILARY",
        "authorized_official_middle_name": "CLAIRE",
        "authorized_official_title_or_position": "SOLE PARTNER",
        "authorized_official_telephone_number": "612-618-5444",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany L Denucci
• Christopher David Denzler
• Christine Charlotte Depenthal
• Bruce James Derauf
• Derin J Van Loon OD PA
• Dale Edward Derocher, MS
• Kristy Lynn Derosia, R.D.H
• Cathy Jo Derosier, RN
• Constance Jeanne Derungs
• Christine Helen Desjardins, PHARMD

• Dermatology Physician in Duluth, MN
• Providers in Duluth, MN by specialty
• Dermatology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.